Individual
MR. ERIC PORTALATIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 ZACALO WAY, KISSIMMEE, FL 34743-9547
(407) 910-8112
Mailing address
120 ZACALO WAY, KISSIMMEE, FL 34743-9547
(407) 910-8112
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12863
PR
Other
Enumeration date
03/26/2015
Last updated
03/26/2015
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